Evaluation and Management Changes for 2021
Effective January 1, 2021, Evaluation & Management Codes for office visits have changed. E/M levels are now determined by time or a new Medical Decision Making matrix. See Downloadable PDFs below for details.
For more information or to get answers to questions, visit ACOG’s Payment Advocacy and Policy Portal.
2021 Evaluation and Management Summary
2021 E/M Desk Reference
New Patient Visits
2021 CPT Code | Code Description | Medical Decision Making | Total Time |
---|---|---|---|
99201 |
Deleted Code |
Deleted |
N/A |
99202 |
Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using time for code selection, 15–29 minutes of total time is spent on the date of the encounter. |
Straightforward |
15–29 |
99203 |
Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using time for code selection, 30–44 minutes of total time is spent on the date of the encounter. |
Low |
30–44 |
99204 |
Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using time for code selection, 45–59 minutes of total time is spent on the date of the encounter. |
Moderate |
45–59 |
99205 |
Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 60–74 minutes of total time is spent on the date of the encounter. |
High |
60–74 |
Established Patient Visits
2021 CPT Code | Code Description | Medical Decision Making | Total Time |
---|---|---|---|
99211 |
Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s) are minimal. |
N/A |
N/A |
99212 |
Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using time for code selection, 10–19 minutes of total time is spent on the date of the encounter. |
Straightforward |
10–19 |
99213 |
Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using time for code selection, 20–29 minutes of total time is spent on the date of the encounter. |
Low |
20–29 |
99214 |
Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using time for code selection, 30–39 minutes of total time is spent on the date of the encounter. |
Moderate |
30–39 |
99215 |
Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40–54 minutes of total time is spent on the date of the encounter. |
High | 40–54 |
Coding Products & Resources
CHEC Your Practice Podcast
Don't Miss! E/M Changes for 2021
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